Welfare and education: the two initial priorities of a Cameron government

mart

Peter:

"granting independence to the NHS bureaucratic elite"

Why not? (seriously)

I think this is a fine idea. Give them their budget and let them get on with it.

In parallel, find a way of measuring outcomes, in a way consistent with other developed countries. And publish the numbers.

Too simple? Too good to be true? Probably.

But what other way is there to run things than to give the job to professionals and make them accountable for outcomes?

Tiberius

The wasteland that the Tories will inherit will cover just about every area of policy, such that any universal, meaningful changes will take two terms. So where to start?

The economy and transport, for example, and the NHS are bigger tasks than education and welfare. The latter should be a relatively simple question of changes to the laws on benefit entitlement, and after my querying of Fraser on how teachers in Sweden reacted to their system change, I am happy that the remaining roadblock, the LEAs, can be circumvented in the education sphere.

So we start with repairing the nation's spiritual health.

I bet one or two wish for an immediate attack on tax levels. I'd like that too, but this has to be managed downward, rather than slashed, to deal with the booby-trapped economy created by Brown.

I'm sure there will be some obvious spending that can be cut, such as Boris has undertaken, but, as every Opposition says, we have to see the books first.

Clive

The real winner is getting real democratic control into the NHS.

That means local control of primary care and regional control of hospital trusts. That can be done by making local authorities responsible directly for the first and by delegates for the second.

That would make local government more important and gain more interest and allow more contact for the people to the managers.

Ian C

NHS bureaucratic independence? providing it truly gives them the rope to hang themselves and there are no bailouts when the screw up.

As for 'NHS' being the three letters Cameron is prioritising, is a missed political opportunity. Blair was right about education - he just did not do anything to back up his proclaimed priority. Cameron should be emphasisins this as being the 'piss and wind' of Nu-Labour. This was very much because Blair could/would not take on the education establishment which is wedded to the Labour Party, for which there is huge support today waiting to cheer him on. In so proclaiming Blair demonstrated a naivete that he cannot be forgiven. Cameron is risking the same misatke with the NHS, about which alot of people are suspicious.

The NHS is now so much the tail wagging the dogsbody of politics. With him committed to continued public financing of it we are likely to suffer the same disappointment. But the Tories are likely to get education more right - and that is more important than anything - so he he should be highlighting Blair's failure to deliver on his mantra.

Norman Briffa

i do not think there is much of an appetite for NHS reform amongst Tory High command - or everyone is keeping strictly stum about their plans even when speaking with you Fraser.
As you correctly say, an independant NHS will only create another layer of bureaucracy that will because of it's independance feel relatively immune from financial constraints and will gobble up even larger amounts of cash. That is the nature of healthcare. You cannot ever have true independance in a tax funded system. Having said that, there is a debate at the moment in the NHS about co-payments i.e. patients topping up their treatments with their own cash.(see latest on BMJ.com) This might be a fruitful area for the Torys to exploit. Maybe cameron will go back to plan A 2005 style that he later disowned.

THX1138

Phew I can cancel my health insurance & stop paying the school fees once Dave's in charge.

David Lindsay

Pure wishful thinking.
How long has the right-wing press been banging on about Eurosceptical, or tough on crime, or committed to traditional family values, the Tories are really?
For that, as for this, there exists absolutely no evidence whatever, but rather, overwhelming evidence to the contrary.

TC

I think the Tories' policy is actually less about giving the NHS per se independence, and more about giving clinicians and hospitals independence.

When you add published outcome measures, patient choice and GP-fundholding, you've actually created a system where healthcare providers are directly accountable to patients - which is really what the aim of healthcare reform should be.